Rex Smith: Wires we fix. But Medicaid?

Late Wednesday afternoon, as a light equinox breeze stirred the Capital Region, an ancient maple tree hollowed out by generations of insects and rodents gave way on my neighbor’s lawn. Its fall was snagged by a sturdy power line, which in turn yanked down two wooden poles, including one near my driveway that split vertically, leaving a transformer hovering near the ground and a tangle of wires on the street. The racket of splintering wood terrified my hound, who was about to take a nice afternoon walk with my wife. She wasn’t pleased, either — my wife, that is — but she called 911. Firefighters showed up quickly to divert drivers and an oblivious jogger who nearly ran into the shock of his life in the dusky light.

Here is what happened next: A National Grid crew pulled up, the first detachment of a changing troop that stayed on the scene through the night, working steadily for more than 16 hours until power was restored, with new poles and wires back in place. When they left, some time after I had ferried my daughter to school the next morning, only some wood shavings alongside the road showed evidence of the near disaster.

At about the time the hardworking utility crewmen were finally leaving my neighborhood, I was sitting in an editorial board meeting where the topic was National Grid’s plan to raise electric rates upstate by $396 million. You’ve probably read our stories about some of the questionable activity uncovered so far by regulators reviewing National Grid’s proposal: private school tuition for an executive’s daughter, for example, and the cost of shipping another boss’s private wine collection from England, where National Grid is based, to America. Naughty, those Brits, to think of nailing us for those perks. Thank goodness the government auditors caught up with them before they could pull it off.

Utility companies are a pretty easy target for our anger, because they operate as monopolies, meaning you have to pay them unless you choose to heat with woodchips and read by moonlight. We tend to think of them only when bad things happen (power goes out — why can’t they get it back on sooner?) or rates go up (greedy executives — that is, paid more than I am). Actually, your underlying electric rates aren’t much changed from a decade ago, thanks, no doubt, to regulators’ watchful eye.

About the only people more unpopular than utility bosses may be state senators, and I’m still betting most of them will get re-elected. Yet electricity flows a lot more dependably than the legislative process. That’s worth thinking about.

Consider: We depend increasingly on alternating current, and we’re generally not disappointed. A new nationwide survey found that 55 percent of Americans now consider home air conditioning to be a necessity, along with one-third who say they can’t live without high-speed Internet and one in 10 who consider a flat-screen TV to be simply and absolutely essential to life. (Yes, you are right to be worried about those people.)

So maybe we can take a page from the utilities as we look at the fairly radical changes that are surely in store as government reshapes itself for our new Era of Never-Ending Deficits.

Take, for example, the looming crisis that is Medicaid, the government program that provides health care for the poor and the chronically ill. One-fourth of all New Yorkers are Medicaid patients, and the bill equals more than one-third of all the money New York spends each year. The cost is growing at a disastrous rate. It is a key reason New York’s state and local tax burden is the nation’s highest.

Ask politicians how to fix Medicaid, and most suggest two things: root out fraud — a response so simplistic as to be a fraud in itself — or restrict benefits, which to make a real dent in costs would have to be done on a scale bordering on cruelty to our vulnerable neighbors. Neither is sufficient, by themselves or taken together.

To this often specious debate comes Lt. Gov. Richard Ravitch, who last week laid out what seems at first blush to be a thoughtful reform plan. Predictably, it drew howls of protest, notably from the Legislature. One of Ravitch’s ideas is to remove the power to set Medicaid rates from legislators and give the job to a presumably less politically sensitive administrative office, backed by a professional advisory council. That’s not unlike the way utilities are overseen.

From the lawmakers’ reactions to this outrageous notion, you’d think their oversight of this crucial government service has been something we should cherish. In fact, they have left it tottering toward a collapse as dramatic as the fall of that tree by my house.

That crisis brought an impressive response from the government-regulated system. Maybe that’s not such a bad approach as we explore how to save something that for many citizens is a lot more essential than a flat-screen TV.

Rex Smith

2 Responses

your comment on medicaid costs is well taken, but, and here is important aspect, state legislators are using this program, particularly in New York City, for votes.
Of note is Chemung County’s manager, Tom Santulli, has worked to lower medicaid costs in their nursing home. Another is the recent
“medicine pickup” by 3400 police departments across the country. But, no mention of your local effort.
You’re not going to reduce welfare costs as long as it insures politicians tenure

Couldn’t get your full response on Medicaid and National Grid article. But, thanks anyway. Trouble when one ages you get too old to fight, and too young to die, and polticians don’t listen anyway. Thans for listening